Alarming rise in fines for wrongly claiming free prescriptions

More people in England are trying to claim free prescription medicine they are not entitled to, or doing so by mistake.

The number of fines issued to patients in England for incorrectly claiming free prescriptions almost doubled to 979,210 in the period 2016/17, compared to 494,129 in 2015/16.

The fines are issued by the NHS Business Service Authority (NHSBSA) and the dramatic rise could be due in part to a firmer policy in pursuing fines, as well as a growing number of people caught out. In some cases, people who have previously had an ‘exemption certificate’ excusing them from paying for prescriptions forget to renew their paperwork when it expires, or are unaware it has expired. Patients can be fined up to £100 for obtaining free prescription medication after an exemption certificate has expired.

A prescription in England currently costs £8.60, so the cost for people needing multiple prescription items can be considerable, especially for long-term-conditions. For some people a three or 12-month Prescription Prepayment Certificate (PPC) is a more cost-effective option. A three-month PPC costs £29.10 and will save you money if you need more than three prescribed items in three months. A 12-month PPC costs £104 and will save you money if you need more than 12 prescribed items in a year.

However, some patients in England object in principle to paying for their prescriptions which would be free in either Scotland or Wales, whose devolved governments have decided to provide free NHS prescriptions. This could also be one of the reasons behind the sharp rise in fines for people claiming free prescriptions when ineligible to do so.

People entitled to free prescriptions in England are:

Those over 60, under 16, or aged 16 to 18 and in full-time education

Those with a specified medical condition who have a valid and current medical exemption certificate

Women who are pregnant or who have had a baby in the past 12 months and have a maternity exemption certificate

Those with a continuing physical disability which prevents them from going out unaided and who have a valid exemption certificate

Anyone who is currently an NHS inpatient

Those who hold a valid war pension exemption certificate, provided the prescription is for their accepted disability.

You might also be entitled to free prescriptions if you, or your partner, receive certain benefits such as Income Support, but otherwise you need to pay for your prescriptions. Fines issued for wrongly claiming free prescriptions amounted to almost £13.3m. in 2016/17, but the Royal Pharmaceutical Society said fines often stemmed from people making mistakes rather than deliberately trying to evade costs. In many cases, they did not fully understand the rules, or forgot to renew their exemption paperwork.

Meanwhile, the British Medical Association said those on low incomes and with long-term conditions were hardest hit by prescription costs. Its spokesman, Dr Richard Vautrey, said that in many cases those people most likely to be fined were also those least able to afford to pay.

“They are often people who have multiple conditions who may need regular prescriptions, and that costs an awful lot of money,” he said, adding that fines should be a “last resort”.

Defending its position, a spokesman for the NHSBSA stressed it was the patient’s responsibility to ensure they were eligible to claim free prescriptions, including making sure their exemption certificate (if they had one) had not expired.

“When a patient makes a declaration on the back of a prescription form it is their responsibility to make sure that they do hold the exemption that they are declaring they have,” said the spokesman.

He added that fraudulent claims and other mistakes cost the NHS millions of pounds which could otherwise be spent of frontline health services.

Next week will bring the shortest day of the year, on December 21st, and with the shortest day comes the longest night. Unfortunately, the long dark nights also mean that this time of year traditionally sees an increase in the number of burglaries.